By Philip Larkin
Larkin writing from a woman’s point of view, like Wedding Wind (here).
Although ostensibly by “Brunette Coleman”, the pseudonym he used for his mildly pornographic girls school stories, this poem is serious and convincing. “Grass between clear-cut lips, that never yet/Thrilled to the rouge” just erotic enough for the pre-teen girl. The ending is pure Larkin.
He never published it.
Fourth Former Loquitor
A group of us have flattened the long grass
Where through the day we watched the wickets fall
Far from the pav. Wenda has left her hat,
And only I remain, now they are gone,
To notice how the evening sun can show
The unsuspected hollows in the field,
When it is all deserted.
wwwwwwwwwwwwwHere they lay,
Wenda and Brenda, Kathleen, and Elaine,
And Jill, shock-headed and the pockets of
Her blazer full of crumbs, while over all
The sunlight lay like amber wine, matured
By every minute. Here we sprawled, barelegged,
And talked of mistresses and poetry,
Shelley and Miss LeQuesne, and heard the tale
Once more of Gwyneth and the garden rake,
Grass between clear-cut lips, that never yet
Thrilled to the rouge: a schoolbag full of books,
(Todhunter’s Algebra – for end of term
Does not mean you can slack) and dusty feet
Bare-toed in sandals – thus we lay, and thus
The filmy clouds drew out like marble veins,
The sun burned on, the great, old whispering trees
Lengthened their shadows over half the pitch:
Deckchairs that the governors had filled
Grew empty, and the final score was hung,
To show for once the Old Girls had been licked.
Ah what remains but night-time and the bats,
This flattened grass, and all the scores to be
Put in the magazine?
wwwwwwwwwwwwwBe not afraid,
Brenda and Wenda, Kathleen and Elaine
And brown-legged Jill – three years lie at your back
And at your feet, three more: in just a week
The end of term will part us, to the pale
And stuccoed houses we loved so much.
Wenda. Brenda, Kathleen and Elaine
Have flattened down the long grass where they’ve lain,
And brown-legged Jill has left her hat,
For they’ve gone to laugh and talk with those
Who’ve played the Old Girls’ match out to its close.
James Booth, in his new biography (click here), suggests Fourth Former Loquitor owes something to this poem by Dorita Fairlie Bruce (click here), author of the Dimsie girls school stories in the 1920s.
To the Old Girls of Clarence House, Roehampton
O Schoolmates of the long-ago!
Though scattered now, and far away
From that white-pillared portico,
And flower-fringed terrace, and the wide
Green playing-field, and all beside
That made our world – come back, I pray!
Forget, for just a little space,
The broadened lives of later years-
Come back again and take your place
At scribbled desk of easel-stool,
In those old days which were so full
Of such tremendous hopes and fears.
I wove you rhymes and stories then,
So here’s one more if you will deign
To turn your footsteps back again,
And tread the class-rooms and the stairs,
Join in the morning hymn at prayers,
Or tread the wood’s leaf-shaded lane.
And if from words of mine you catch
One breath of the old cedars’ scent-
Hear blithe young voices cheer the match,
Across the sunny field, or see
Forgotten faces flushed with glee-
I shall be well-content.
Dorita F. Bruce
By Clive James
Clive James, essayist, commentator and poet, is terminally ill with leukaemia, but he’s retained his faculties. This was in yesterday’s New Yorker.
Your death, near now, is of an easy sort.
So slow a fading out brings no real pain.
Breath growing short
Is just uncomfortable. You feel the drain
Of energy, but thought and sight remain:
Enhanced, in fact. When did you ever see
So much sweet beauty as when fine rain falls
On that small tree
And saturates your brick back garden walls,
So many Amber Rooms and mirror halls?
Ever more lavish as the dusk descends
This glistening illuminates the air.
It never ends.
Whenever the rain comes it will be there,
Beyond my time, but now I take my share.
My daughter’s choice, the maple tree is new.
Come autumn and its leaves will turn to flame.
What I must do
Is live to see that. That will end the game
For me, though life continues all the same:
Filling the double doors to bathe my eyes,
A final flood of colors will live on
As my mind dies,
Burned by my vision of a world that shone
So brightly at the last, and then was gone.
The columnist and childcare expert hasn’t a bad word to say about post-menopausal hormone replacement therapy (HRT).
On her website (click here), advising about menopause management: “The single most effective tool available is HRT. [...] [It] is more than 90 percent effective. If you feel your doctor isn’t being very helpful or sympathetic, or won’t let you try hormone replacement therapy, seek an opinion from another doctor.”
Referring to osteoporosis she writes: “Consider HRT once you are menopausal. Taking oestrogen in combination with progestogen for 10-13 days a month seems to optimise bone health and prevent fractures”. She fails to mention any risks, or that HRT is only recommended for osteoporosis prevention in women at high risk who cannot tolerate alternatives.
In 2012 in an article entitled “Why HRT is safe to combat menopause despite past scare stories” she linked the increased risk of cardiovascular disease identified in the WHI trials with the MMR/autism scare, and claimed without reference: “it’s been shown that HRT cuts the risk of heart disease in younger women”. (Click here).
In 2011 (click here) in response to a question from a patient whose GP was reluctant to prescribe HRT because of a strong family history of breast cancer (grandmother, aunt and cousin), she wrote: “HRT is better than any other menopausal remedy by a long stretch”, suggested getting a second opinion, and ended: “I’m hopeful your gynaecologist will find a way to give you HRT”.
This is biased advice. Since the Women’s Health Initiative trials confirmed that HRT increases the risk of breast cancer, heart disease and strokes, all governments have advised that it should limited to treating symptoms only, and used in the lowest dose, for the shortest time possible, and never for health promotion. The idea that it might reduce heart disease when started soon after the menopause is not born out by independent analysis of all the trial evidence, e.g. the latest Cochrane review here. It remains a fringe obsession of a few “experts” with ties to the HRT industry. Dr Stoppard is entitled to her views but she also has a conflict of interest.
According to Debrett’s People of Today (click here) she worked for Syntex Pharmaceuticals Ltd between 1968 and 1981. She was associate medical director 1968-71, deputy medical director 1971-74 & 76 , and medical director 1974-76, & 1977-81. In 1991 she became a director of the Syntex Corporation and remains so to this day. Syntex manufactures and sells HRT.
I wonder why she forgets to mention this on her website, or in any of her HRT articles.
Early postmenopausal HRT does not prevent vascular deterioration
There is good evidence that post-menopausal hormone replacement therapy (HRT) increases heart attacks and strokes. However, most of the patients in the randomised trials that provided that evidence started HRT or placebo 10 years or so after the menopause, and some had pre-existing heart disease. Perhaps HRT started earlier in healthy women is preventive. This “timing hypothesis” is popular with HRT manufacturers.
The Kronos Early Estrogen Prevention Study (KEEPS) tested the timing hypothesis by studying healthy women within three years of the menopause. They were divided into three groups and treated for 48 months as follows:
1) oral conjugated equine estrogens (o-CEE), 0.45 mg/day, plus progesterone 200 mg for 12 days/month.
2) transdermal 17β-estradiol (t-E2), 50 mcg/day, plus progesterone 200 mg for 12 days/month.
The primary endpoint was change in carotid artery intima-media thickness (CIMT), a measure of the vascular damage which precedes heart attacks and strokes. The trial was randomised, double blind, registered here before starting, and follow-up of the 727 participants was completed two years ago – I grumbled about the delay in publication here. The results have just been published in the Annals of Internal Medicine here, or Keeps trial report.
HRT doesn’t protect the arteries. Here is the change in CIMT over time in the three groups. Larger change means more artery wall thickening, a sign of damage. Arteries in all three groups deteriorated over time but, although the deterioration was slightly greater in the two HRT groups, the difference was not statistically significant.
The trial was too small to say much about substantive health outcomes – one woman died of an unspecified pelvic maligancy in the o-CEE group, and there was one non-fatal heart attack in the t-E2 group. There were no deaths or heart attacks in controls, and no strokes in the whole trial.
It’s a nice paper. It shows the power of good trial design – double blind, registered, sample size achieved, primary endpoint pre-defined and analysis by intention to treat.
The authors, mostly supporters of the timing hypothesis, were disappointed, but the many women who will avoid taking HRT in the vain hope of preventing heart disease should not be.
The best advice remains – if you must take HRT, take it for symptoms only, in the lowest dose and for the shortest time possible.
A431 toll road
In February 2014 a landslip on the A431 between Bristol and Bath opened cracks in the road and forced a 14 mile diversion. It was tricky to repair; the council estimated it would be closed till the end of the year, and that a temporary bypass would cost £1.6M and take 16 weeks to build.
So in August local businessman, Mike Watts, took matters into his own hands and built a diversion a few hundred yards up the hillside. It took three men ten days, and £150,000; plus a further £1,000 per day to operate. So long as the council don’t speed up, £2 per car should pay for it.
It’s the first new toll road in Britain since the M6 bypass, and the first privately built one for at least a hundred years.
We need more. Let’s replace the “free” tarmac we currently overuse with correctly priced alternatives. Imagine the pollution that could prevent.
Heparin prophylaxis in pregnancy
The TIPPS trial, published online in The Lancet this week (click here), shows that among high risk women, heparin thrombo-prophylaxis does not reduce adverse pregnancy outcomes, and increases rates of bleeding. The researchers did a great job, and their findings will protect many women from these toxic drugs. In passing they also reminded us of the importance of trial registration.
Did unregistered trials get it wrong?
Figure 3 (above) shows the results of all seven heparin thrombo-prophylaxis trials to date. The top four, Rey, Gris 2010, Gris 2011, and Mello, were unregistered and all showed an implausibly large beneficial effect. The bottom three, Martinelli, De Vries, and Roger, (Roger = TIPPS) were registered in advance so the researchers could not stop early, decide not to publish, or alter their primary outcome, without someone noticing. None showed a benefit.
The TIPPS authors half suggest that the truth lies somewhere between the two groups, namely the “combined (random effects)” relative risk line at the bottom of the figure. I doubt it! More likely the top four trials got their false positive results by repeatedly peeking at their data, selective choice of endpoints or selective publication. The bottom three show the truth.
TIPPS researchers also silently altered sample size
It seems churlish after all that, to question the TIPPS trial methods, but “needs must”. In the published paper the authors claim to have “aimed for a sample size of 284”. Recruitment ran from 28 Feb 2000 to 14 Sept 2012 and the trial was first registered with Clinicaltrials.gov (click here) on 29 May 2009. Between then and 23 April 2013 the Clinicaltrials.gov archives (click here – variable 27) recorded anticipated recruitment of 385 – that’s 101 more than they claimed in the paper! This was altered to 284 on 23 April 2013, and changed again to the actual recruitment number of 292 on 16 May 2013. None of this is mentioned in the published paper. Tut tut!
The TIPPS results were negative, so perhaps this doesn’t matter. Presumably the authors stopped early because they ran out of money, rather than because they had peeked at the data and discovered a nominally significant result. But imagine if TIPPS had been positive. Readers would have assumed that they had cheated.
The third German river
Unlike the Rhine and Elbe, the Weser can be canoed from its origin. It starts not as a tiny stream, high in the hills, but fully formed at the junction of the rivers Werra and Fulda at Hann. Munden. The sea at Bremerhaven is 450km away, but the lower sections, below the junction with the Mittleland canal at Minden, have much heavy shipping – scary.
The section from Hann. Munden to Hameln, the home of the Pied Piper, has no locks, plenty of campsites and perhaps two barges and a few tourist boats a day. It is fast flowing – five easy days paddle – and about a days driving from Dover. I used the Hann. Munden – Cuxhaven Radwander-karte (click here) .
0 km – Launch from the car park on the island at the junction of the Werra and Fulda at Hann. Munden, or from the campsite on the Fulda island 100 yards upstream. http://www.fahrrad-kanu-touren-weser.de/
Or launch into the Fulda above the lock and paddle to the right of the island. The weir, with its hydro-electric power station right, has a canoe shoot left.
Good landing stage/launch spot just below the last Fulda lock by the campsite.
0.5 km – road bridge B3/B80
5 km – Hilwartshausen Abbey left
5.5 km – gravel pits right
11 km – ferry. Reinhards-hagen left. The small village of Hemeln right is not the home of the Pied Piper. That’s at 133 km.
Statue of the legendary giantess Brama on the left bank downstream of the town.
Wesercamping Hemeln http://www.wesercamping.de/ The main site is set back from the river but they allow camping on the bank.
17 Km – Glashutte. Youth campsite right
19 Km – River Nieme joins right. Bursfelde Abbey right
22 km – Weisse-hutte camping left
25 Km – Ferry. Oedelsheim right.
25.5 km – Camping right. http://www.campen-am-fluss.de/ Lovely site. Kanu Shumacher trips launch from here.
28 km – Camping left
29 km- Bridge. Gieselwerder left
33 Km – Ferry. Lippoldsberg right
34 km – Bodenfelde right.
35 km – Wahmbeck ferry
Look out for this structure on the left, just before Bad Karlshafen bridge .
It filters the local mineral water through a network of twigs, creating a briny vapour which is supposed to have health giving properties. Probably does as much good as most alternative therapy. At least if you’re sitting next to it, no-one’s operating on you, or filling you with harmful drugs.
43 km – bridge. Bad Karlshafen left.
Camping below bridge on right. http://www.campingplatz-bad-karlshafen.de/
The harbour and locks connecting the Diemel navigation to the Weser are now disused.
44 km – Diemel river joins left
46 km – ferry. Herstelle left. Wurgassen right
48 km – road bridge. L763
50 km – Wurgassen nuclear power plant right
Built in 1968, with an output of 640MW, Wurgassen was one of Germany’s first commercial nuclear power stations. It was shut down in 1995 because cracks had been detected in the steel reactor container. Precautionary, there had been no leak. It is currently being dismantled.
52 km – Beverungen boat club left allows camping. Excellent facilities.
There is also a campsite on the right bank opposite, albeit set back from the river bank
53 km – road bridge. Beverungen left
Honesty book exchange in centre of town. Take one leave one.
57 km – railway bridge
25 miles – ferry. Wehreden left
Schloss Furstenberg right bank at the end of a straight reach. Famous for porcelain. Look how the cliffs have wooded over in the last 100 years.
63 Km – railway bridge. River Nethe enters left just downstream
Camping right Wesercamping Hoxter
27.5 miles – bridge. Hoxter left
28.5 miles railway bridge. Schloss Corvey left immediately after the bridge, previously a Bendictine monastery, and now a UNESCO world heritage site, is hardly visible from the river. Camping left in the castle grounds (click here)
73 Km – bridge. Luchtringen right
80 km – Holzminden bridge. Camping left before bridge. Holzminden right
The old harbour right just before the bridge. Landing spot. Youth hostel adjacent.
81 km – Holzminden by pass bridge
91 km – Weserbergland camping left http://www.weserbergland-camping.de/ Heisen left. A very scenic village.
93 km – Eversteiner castle left. Allegedly the home of Cinderella’s prince. Hmm? Ferry. Polle left. Campingplatz Weserterrassen left http://www.weserterras
94 Km – Brevorde left
97 km – Solar Ferry. Grave left.
99 km – Dolme right. Steinmuhle cliffs left
102 km – Pegestorf left. The harbour is long disused, and the campsite marked on the map on the left bank just downstream didn’t exist in May 2014. But no worries – two lovely sites on the right bank soon after Rühle.
103 km – Ruhle right Click here for the cemetery
104 km – Campingplatz Rühler Schweiz right. http://www.brader-ruehler-schweiz.de/campingplatz-ferienwohnung-bodenwerder.htm
106 km – Campingplatz Himmelspforte right. http://www.camping-weserbergland.de/
109 km – Bridge. Bodenwerder left.
109.5 km – Bodenwerder railway bridge
110 km – Bodenwerder bypass bridge
114 km – bridge. Daspe right. Hehlen left.
118 km – Ferry. Hajen right
120 – Ferry. Grohnde left
122 km – Latferde right.
123 km – Grohnde nuclear power plant left.
This beautiful 1430MW pressurised water reactor, built in 1984, and operated by EoN, runs on both normal uranium and reprocessed MOX fuel from Britain and France, making it one of the most efficient in the world; eight times it has produced more electricity in a year than any other nuclear power station.
In a panic after the Fukushima nuclear leak in 2011 the Germans decided to phase out all nuclear power by 2022, and unless someone sees sense, Grohnde will go.
124.5 km – bridge. Emmerthal left. Hagenohsen right
125 – railway bridge
126 km – Tundern windmill set back from the river right
127 km – Ferry. Ohr left
132 km – camping right
133 km – bridge Hameln right. Home of the pied piper
134 km – weir. Lock left. Island. Canoe shoot. Weir. Bridge. Island. Lock. Weir. Hydroelectric power station.
The main road bridge in Hameln crosses the weir